CurrentBlue Cross Blue Shield - New MexicoPolicy CPCPLAB048

Folate Testing

Defines Blue Cross Blue Shield of New Mexico reimbursement stance for serum and red blood cell folate tests and folate receptor autoantibody testing; applies to providers submitting claims to BCBSNM.

Policy Summary

PayerBlue Cross Blue Shield - New Mexico

PolicyFolate Testing

Policy CodePolicy CPCPLAB048

Change TypeRevised and added coverage rules

Effective DateNov 7, 2025

Next Review DateN/A

Key ActionSubmit accurate documentation and use valid HIPAA code sets when filing claims; claims may be reviewed against plan documents and provider contracts.

SourceLink

POLICY UPDATE CHANGES

Measurement of serum folate concentration may be reimbursable for individuals with megaloblastic or macrocytic anemia and for individuals who have undergone or are scheduled for bariatric procedures.

For all situations, folate receptor autoantibody testing is not reimbursable.

3reimbursement rules listed

3procedure codes listed

07/25/2025last approval / update

Folate Testing Reimbursement Criteria

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Listed procedure codesCPT

82746	Folate; serum
82747	Folate; red blood cell
0399U	Folate receptor autoantibody (proprietary molecular/protein US-specific code)

RBC folate reimbursement

RBC folate reimbursement statusFor all indications, measurement of red blood cell (RBC) folate is not reimbursable.

ScopeApplies to measurement of RBC folate for any clinical indication.

Related serum ruleSeparate guidance exists for serum folate; some serum folate indications may be reimbursable while RBC folate is not.

Documentation and Claims Submission Requirements

Documentation Required

Documentation, coding and claims review requirements

Providers must submit accurate documentation of services performed and submit claims using valid HIPAA-approved code sets; claims are subject to code edit protocols and review. Providers are urged to review plan documents to determine product-specific lab management reimbursement criteria and to provide additional documentation upon request.

Submit claims using valid code combinations from HIPAA-approved code sets (CPT, HCPCS, ICD-10-CM/PCS, NDC, DRG guidelines, etc.).
Claims are subject to code edit protocols and may be reviewed against plan documents, provider contracts, medical policies, clinical payment and coding policies, and coding software logic.
Upon request, submit any additional documentation to support the claim.

Plan Documents and Governing Documents

Plan documents and precedence

Types of plan documentsCertificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents.

Authority in conflictsPlan documents may govern in case of conflict with this policy.

Provider recommendationProviders are urged to review Plan documents to determine product-specific coverage and reimbursement criteria.